Dr. Vivek Chail
General Practitioner
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hello doctor,
For a few weeks, I have a globus sensation in my throat. Also, for a week or two, I have a burning sensation behind my breastplate (acid reflux), and food does not seem to go down as well as it used to go. I have a feeling that food is sticking in my esophagus. I have attached a CT scan of the neck. This study was done because I had one-sided (right) otalgia for months without a proper explanation. After Lidocaine injection, this otalgia has gone away. However, I looked at the CT scan, and when I looked at the part of the esophagus that is visible, I was horrified. I do not think it looks normal, and considering the symptoms I have right now, I am very worried that I might have esophageal cancer. Can you please look at the provided scan and tell me if there is something wrong with my esophagus?
Hi,
Welcome to icliniq.com.
Thanks for writing to us.
There are no features of cancer of the esophagus in the CT neck scan images (attachments removed to protect the patient's identity). There are few small bilateral cervical lymph nodes and are not significant.
The esophagus is collapsed in the given images. A CT neck or chest scan with oral contrast would have been better to see the wall of the complete esophagus.
It is better to do a barium swallow and check for any abnormality in the esophagus's complete length if needed.
There is no infection in the bilateral middle ear cavities.
There are mild prominent nasopharyngeal soft tissues on the right, but they do not look significant.
Regards.
Patient's Query
Hello doctor,
Thanks for your reply. Were you able to see all the attached CT-scans?
For example, in the attached picture: it seems the esophagus wall is thickened (and thicker than the maximum normal value of 5 mm). What do you think about that? I am very worried about having esophagus cancer since I have a lot of symptoms relating to this disease, and my scan looks like pictures online of people having esophagus cancer. Could you please elaborate a little bit more on what you see regarding the esophagus and why you consider it normal?
Thank you so much.
Kind regards.
Hi,
Welcome back to iclinq.com.
Thanks for writing to us.
I have reviewed the images and your concerns about the wall thickening of the esophagus. When measuring the esophageal wall thickness, we are at a disadvantage as there is no contrast in the lumen. This is causing a collapse of the walls of the esophagus as visualized in the picture and showing a likely false wall thickening. This is the reason to call it normal. A confirmed interpretation would need an X-ray barium swallow or doing a CT scan with oral contrast.
Regards.
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General Practitioner
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